OHSU Digital Collections (Oregon Health and Science University)

Novel anti-CB1 monoclonal antibodies, including an N-terminal binding antibody, were characterized and validated. These antibodies were then used to investigate the role of the CB1 N-terminus in subcellular localization. Finally, the ability of one antibody was assessed for immunoaffinity purification.  In this thesis, I detail the characterization and validation of several novel monoclonal anti-CB1 antibodies as well as several applications of these antibodies

Matheson, Triona

Characterization and validation of novel anti-CB1 monoclonal antibodies and their application to GPCR studies

On Healthy People 2030, one of the sleep objectives is to increase the proportion of high school students who get enough sleep. This objective is listed as "Getting Worse" which indicates that we are further from meeting our target than we were at the beginning of the decade. As such, it is imperative that we focus our efforts in increasing this proportion for not only teenagers' current health & well-being but for their future health as well. Given that the CDC recommends 8 - 10 hours a night, it is important to research the multiple strategies that teenagers can utilize to achieve this amount. There are many different strategies/best practices that teenagers may employ in order to get enough sleep which is outlined throughout this paper

Silva, Maria

Maria “Mo” Silva, PA-S2 
OHSU School of Medicine 
Physician Assistant Program 
 
Effective Strategies to Improve Sleep and Academic Performance Among High School Students 
 Sleep is a very complex and dynamic process. It is imperative for individuals of all ages 
to get enough sleep to form and maintain pathways in the brain. These brain pathways assist in 
the ability to learn and create new memories. Adolescence is a crucial time for brain maturation. 
As such, it is recommended that teenagers aged 13 – 18 years get 8 – 10 hours of sleep per 24 
hours.1 It is outlined that sleeping the number of recommended hours on a regular basis is 
associated with improved attention, learning, and memory. If high school students get inadequate 
sleep, brain maturation may be negatively impacted resulting in poor academic performance.2 
Sadly, according to Healthy People 2030, only 22.1% of students in grades 9 through 12 get 
sufficient sleep on an average school night.3 This data was collected from high school students at 
a national level. These students are recognizing and self-reporting that they feel they are not 
getting sufficient sleep. Therefore, it is critical to provide education to high school students about 
sleep hygiene and the various strategies they can utilize in order for them to get sufficient sleep 
and improve their academic performance.  
In order to establish strategies to increase the number of hours as well as the quality of 
sleep for high school students, it is important to discuss the physiological process of sleep and 
the necessity for sleep. During sleep, the brain sorts and reinforces the newly encoded memories 
that were made during wakefulness. This process, called consolidation, leads to the generation of 
long-lasting memory traces or engrams whose activation during wakefulness supports the recall 
of information.4 If students are frequently sleeping only a few hours each night, the consolidation 
process is hindered. This memory hindrance can result in poor academic performance. In a 
systematic review and meta-analysis, it was discussed how five studies found sleep duration to 
be positively associated with grades such that those reporting longer sleep durations also 
reported higher grades than their peers reporting shorter sleep durations.2 Additionally, this same 
journal article found a significant correlation between sleep quality with overall academic 
performance. Students who had restful and undisrupted sleep had better grades when compared 
to their peers with poorer sleep quality.2 It can be difficult to motivate individuals to advocate for 
their health, especially teenagers. As such, if high school students are aware of the potential 
academic repercussions of continued sleep deprivation, they might start implementing change in 
their current sleep habits. Furthermore, given that the audience are all high school students 
enrolled in a health careers course, there is a significant emphasis on attaining good grades for 
their future education and endeavors.  
Consistency in sleep habits can promote healthy sleep. The American Academy of Sleep 
Medicine (AASM) discusses that alterations in daily routines and behaviors can have a 
deleterious effect on sleep quality.5 The suggested best practices include keeping a consistent 
sleep schedule in which students set a bedtime that is early enough to get 8 hours of sleep or 
more as well as getting up at the same time every day, even on weekends or during vacations. 
Additionally, it is recommended to limit exposure to bright light in the evenings, exercise 
regularly, maintain a healthy diet, don’t eat a large meal before bedtime, and turn off electronic 
devices at least 30 minutes before bedtime.5 The American Academy of Pediatrics endorse these 
recommendations outlined by the AASM. In applying these techniques on a consistent basis, 
adolescents may experience longer durations of sleep as well as restful sleep. Parents and 
guardians of the high school students are encouraged to assist in the routine of their consistent 
sleep schedule.6 The consistency in teenagers’ sleep habits is a collaborative effort between the 
teenagers themselves and their guardians. If families are able to provide structure and support for 
their teenagers, they will be more likely to get the recommended hours of sleep each night.  
In addition to parental and guardian assistance, changes within the schools can also 
support the sleep needs of high schoolers. When compared to children and adults, adolescents 
tend to fall asleep and wake up later. The current sleep-wake schedules set by schools do not fit 
with biological circadian and homeostatic processes regulating adolescent sleep patterns.7 As 
such, researchers wanted to review the latest studies that focused on the primary effects on sleep 
such as total sleep time and daytime sleepiness as well as the secondary effects on daytime 
functioning such as school performance when students in elementary, middle, and high school 
had a delayed start time. Most cross-sectional and longitudinal studies reported an increase in 
total minutes of sleep following later school start times.7 Additionally, it was found that students 
who had a later start time at school had a significant enhancement of attention level during 
class.7 This increase in attention can be attributed to longer sleep durations and a decrease in 
daytime sleepiness. There are many factors that interfere with school districts altering their 
current start times. A few of these factors include overlapping bus schedules, working parents, 
funding, and after school extracurricular activities. Even though it is unlikely that schools will be 
able to accommodate an indefinite “late start” schedule change, juniors and seniors in high 
school can be encouraged to opt for the “late arrival” option rather than the “early dismissal” 
option when creating their class schedule. By selecting a later start time, students will get more 
sleep and subsequently have an increase in attention within the classroom. This improved 
attention and lack of daytime sleepiness can assist in academic improvement.  
With technological advancements, teenagers rely heavily on these types of devices for 
academic learning and benefits. However, it is no secret that teenagers also rely heavily on 
technology for the social benefits. Therefore, it can be difficult to find incentives to encourage 
teenagers to put away these devices at bedtime. Prior to addressing this hurdle, it is important to 
provide students with the data regarding the relationship between screen time and sleep. There 
are a multitude of previous studies that have found that higher use of passive devices such as 
television and interactive devices such as laptops, phones, tablets, and videogames have delayed 
bedtimes as well as shorter self-reported sleep duration in children aged 4 – 18 years.8 However, 
little is known regarding the objective sleep measures. Because of this, researchers wanted to 
investigate the relationship between the use of screen devices and subjective and objective sleep 
measures in adolescents aged 17-18 years. To assess subjective sleep, the Pittsburg Sleep Quality 
Index was utilized by participants which is a self-rated questionnaire which assesses sleep 
quality and disturbances. To assess objective sleep, the ActiGraph watch which measures activity 
through light and movement to assess sleep-wake cycle was worn by participants for seven 
nights. It was found that mean adolescents’ amount of sleep was approximately 6 hours and 48 
minutes. Daytime sleepiness was correlated with lower sleep quality and correlated with shorter 
total sleep time.8 The results of this study demonstrated that higher tablet use and mobile phone 
use were associated with decreased sleep efficiency and increased minutes of wake time after 
sleep onset. As such, these findings demonstrate that blue light screen exposure and mental 
arousal play an important role in sleep. In another study, it was found that active screen time was 
associated with more sleep-onset difficulties among adolescents compared to passive screen 
time.9 As such, if the students initially find it difficult to limit screen time, it is preferred they 
watch television rather than play videogames as passive screen time does not result in sleep-
onset difficulties when compared to active screen time. Small goals that high school students set 
for themselves can ultimately result in big strides in the improvement of their sleep habits.   
As mentioned earlier, the audience for this community outreach presentation is comprised 
of high school students enrolled in a health careers course. Many of these teenagers will continue 
to be students in the many years to come. If they develop poor sleep habits in their younger 
years, there can be long-term detrimental consequences in their future education. Therefore, it is 
worth sharing the insight from students enrolled in graduate level health education programs. In 
an effort to adjust and cope with the strenuous workload and stressful environment, many 
students in graduate school tend to reduce their sleep. As such, a cross-sectional study was 
conducted to estimate the prevalence of and the relationship between poor sleep quality and 
stress among medical students.10 It was found that there was a high prevalence of poor sleep 
quality (76%) and stress (53%), with a statistically significant association (p < 0.001). Within the 
article, it was recommended that medical colleges establish academic counseling centers focused 
in promoting good sleep hygiene, strengthening students’ study skills, and coping with their 
stressful environment.10 This recommendation should be implemented not only in the medical 
colleges but the high school programs as well. Support from an advisor or academic counselor is 
vital to the academic success of their advisees. Establishing strong sleep habits & techniques 
now while in high school will prepare students for their future schooling as well as to avoid 
possible burnout. 
Substantial research has been conducted to develop guidelines and tips for individuals 
who have poor sleep habits. These beneficial sleep strategies are known as “sleep hygiene.” 
There is much evidence to suggest that these strategies can provide long-term solutions to sleep 
difficulties.11 A few of these tips have been mentioned earlier which include keeping a consistent 
sleep schedule in which individuals set a bedtime that is early enough to get 8 hours of sleep or 
more as well as getting up at the same time every day (even on weekends or during vacations), 
limiting exposure to bright light in the evenings such as technological and/or blue light devices 
as this can alter circadian rhythm, exercising regularly, and maintaining a healthy diet while 
avoiding heavy meals before bedtime. Additional sleep hygiene tips include differentiating 
between bedtime (going to bed) vs. shuteye time (lights off), utilizing the bed only for sleeping 
in which individuals don’t use the bed to watch TV, eat, read, or work so that your body comes to 
associate the bed with sleep, and utilizing a sleep diary in which individuals track their sleep at 
home. A sleep diary allows teens to record when they went to bed, woke during the night, and 
woke in the morning. In completing the diary over the course of a two-week period, teenagers 
can better understand their sleep pattern, how much sleep they’re getting each night, and how 
often they have disrupted sleep.12 The diary also includes tracking the time of day when they 
exercised or drank caffeine. If printing out the diary log and handwriting within the diary seems 
archaic to students, there are many apps and sleep trackers teenagers can download and use on 
their cell phones. Headspace and Calm are popular apps utilized by many individuals who 
encounter sleep difficulties. With regards to stress management, these two apps have meditations 
that can help promote good sleep. However, it is important to note that few sleep apps 
demonstrate empirical evidence to support their claims, and if they do, this evidence can be 
based on significant methodological limitations.13 There are many online resources for students 
to utilize. Providing information via videos as well as handouts with infographics are simple 
ways to engage students and promote better sleep hygiene.  
It is imperative that collaborative efforts are made to increase the proportion of high 
school students getting sufficient and high-quality sleep. Similarly to Healthy People 2030, the 
most recent national data in 2021 from The Centers for Disease Control and Prevention (CDC) 
reported that 77.3% of 13,615 high school students felt they weren’t getting 8 or more hours of 
sleep each night.14 Additionally, the CDC found that the prevalence of short sleep duration 
among high school students increased from approximately 70% in 2009 to approximately 78% in 
2019.15 These worsening statistics demonstrate that this is a major public health issue. We are 
farther from meeting our target than we were at the beginning of the decade. In order to improve 
these numbers, a synergistic effort among students, families, administrations, and communities is 
required. Through utilization of the many effective strategies outlined, high school students can 
improve their sleep as well as their academic performance.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
References 
 
1. Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. 
Recommended amount of sleep for pediatric populations: a consensus statement of the 
American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785–786. 
doi:10.5664/jcsm.5866 
2. Musshafen LA, Tyrone RS, Abdelaziz A, et al. Associations between sleep and academic 
performance in US adolescents: a systematic review and meta-analysis. Sleep Med. 
2021;83:71-82. doi:10.1016/j.sleep.2021.04.015 
3. Office of Disease Prevention and Health Promotion, U.S. Department of Health and 
Human Services. Healthy People 2030. Increase the proportion of high school students 
who get enough sleep. Accessed October 17, 2023. 
https://health.gov/healthypeople/objectives-and-data/browse-objectives/sleep/increase-
proportion-high-school-students-who-get-enough-sleep-sh-04 
4. Girardeau G, Lopes-Dos-Santos V. Brain neural patterns and the memory function of 
sleep. Science. 2021;374(6567):560-564. doi:10.1126/science.abi8370 
5. American Academy of Sleep Medicine. Sleep Education: Healthy Sleep Habits. Accessed 
October 17, 2023. https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/ 
6. American Academy of Pediatrics. AAP News: AAP endorses new recommendations on 
sleep times. Accessed October 17, 2023. 
https://publications.aap.org/aapnews/news/6630/AAP-endorses-new-recommendations-
on-sleep-times  
7. Alfonsi V, Scarpelli S, D'Atri A, Stella G, De Gennaro L. Later School Start Time: The 
Impact of Sleep on Academic Performance and Health in the Adolescent Population. Int J 
Environ Res Public Health. 2020;17(7):2574. doi:10.3390/ijerph17072574 
8. Cabré-Riera A, Torrent M, Donaire-Gonzalez D, Vrijheid M, Cardis E, Guxens M. 
Telecommunication devices use, screen time and sleep in adolescents. Environ Res. 
2019;171:341-347. doi:10.1016/j.envres.2018.10.036 
9. Khan A, Reyad MAH, Edwards E, Horwood S. Associations between adolescent sleep 
difficulties and active versus passive screen time across 38 countries. J Affect Disord. 
2023;320:298-304. doi:10.1016/j.jad.2022.09.137 
10. Almojali AI, Almalki SA, Alothman AS, Masuadi EM, Alaqeel MK. The prevalence and 
association of stress with sleep quality among medical students. J Epidemiol Glob 
Health. 2017;7(3):169-174. doi:10.1016/j.jegh.2017.04.005  
11. Centre for Clinical Interventions. Sleep & Insomnia Self-Help Resources – Information 
Sheets: Sleep Hygiene. Accessed October 20, 2023. 
https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Sleep 
12. American Academy of Sleep Medicine. Sleep Education Resources: Sleep Diary. 
Accessed October 20, 2023. https://sleepeducation.org/resources/sleep-diary/ 
13. Ananth S. Sleep apps: current limitations and challenges. Sleep Sci. 2021;14(1):83-86. 
doi:10.5935/1984-0063.20200036 
14. Centers for Disease Control and Prevention. High School Youth Risk Behavior 
Surveillance: United States 2021 Results. Accessed October 20, 2023. 
https://nccd.cdc.gov/Youthonline/App/Results.aspx 
15. Centers for Disease Control and Prevention. High School Students Sleep Data. Accessed 
Oct 20, 2023. https://www.cdc.gov/sleep/data-and-statistics/high-school-students.html 


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Characterization and validation of novel anti-CB1 monoclonal antibodies and their application to GPCR studies

Effective strategies to improve sleep and academic performance among high school students

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